Special instructions to patients on long term blood thinners (Coumadin or Warfarin).

Note: does not apply to patients on aspirin.

Coumadin® or Warfarin are medications taken by mouth to thin the blood. These medications interact with a number of other medications and even with food items such as leafy vegetables and lettuce. Potency of the drug is often reduced, but may sometimes be increased by ingestion of other substances. Periodic monitoring of the level of blood thinning and appropriate adjustment of blood thinner dosage is therefore vital. This is performed by your local doctor and not by our clinic.

If you are on a blood thinner at the time of discharge, you should contact your local physician and have your blood monitored within 3-5 days after discharge. We will make every effort to give written or oral instructions to your doctor if you are started on blood thinners after surgery to remind him of this requirement. Nevertheless, it is your responsibility to contact your doctor as instructed above. Lack of timely monitoring may result in bleeding or blood clots.

Patients on oral blood thinners may be required to stop them before other surgical procedures, dental work and certain tests requiring needle sticks. Once stopped, it typically takes three to four days for the blood thinner to wear off. Since stopping blood thinners may expose you to formation of blood clots, other special injectable blood thinners may be given while the oral blood thinners are stopped. These injectable blood thinners can be taken relatively safely before other surgical procedures, dental work or special tests.

Some risk of bleeding is still present but is less than with oral blood thinners. Call our office for specific instructions. Be aware that we can make a recommendation for such a switch to you or your other doctor caring for you, but we cannot guarantee that our recommendation will be followed. The final responsibility for such a switch rests with the treating doctor.